Trifluoperazine: Brands, Price & Uses in Bangladesh

Trifluoperazine is a phenothiazine-class antipsychotic (typical/first-generation antipsychotic) with the following evidence-based uses:

Established/approved uses

• Schizophrenia: Management of manifestations of psychotic disorders, including acute and chronic schizophrenia (paranoid, hebephrenic, and catatonic types).
• Short-term treatment of generalized non-psychotic anxiety: Approved only for short-term use (generally not exceeding 12 weeks) at low doses, when other measures have not been adequate; not intended as first-line therapy for anxiety.

Other recognized uses (in some markets, including Bangladesh)

• Nausea and vomiting: Used at low doses as an antiemetic for nausea and vomiting of various causes, based on its antidopaminergic action at the chemoreceptor trigger zone.

Not approved: Trifluoperazine is not approved for treatment of dementia-related psychosis in elderly patients (see Precautions and Warnings for the boxed mortality warning).

Schizophrenia (Adults)

Non-psychotic anxiety (Adults)

1–2 mg twice daily; maximum 6 mg per day, for a maximum of 12 weeks. Re-evaluate the need for continued treatment periodically.

Nausea and vomiting

Low doses (e.g., 1–2 mg once or twice daily) as needed, guided by response; see a physician for the appropriate regimen.

Pediatric use (age 6–12 years)

For psychotic disorders: initial dose of 1 mg once or twice daily, increased gradually as needed and tolerated; total daily dose usually does not exceed 15 mg. Not generally recommended for non-psychotic anxiety in children. See Use in Special Populations.

Elderly patients

Start at a lower dose (often half the usual adult starting dose) with gradual titration; monitor closely for hypotension and extrapyramidal effects.

Administration

Trifluoperazine tablets should be swallowed whole with water, with or without food, at doses and intervals advised by the physician. Do not stop abruptly without medical advice.

Common side effects of Trifluoperazine include:

• Drowsiness, dizziness, and sedation
• Dry mouth and blurred vision
• Extrapyramidal symptoms: tremor, muscle rigidity, akathisia (restlessness), dystonia
• Orthostatic hypotension
• Amenorrhea and hyperprolactinemia-related effects (e.g., galactorrhea, breast changes)
• Constipation

Serious but less common effects (see Precautions and Warnings for details): neuroleptic malignant syndrome, tardive dyskinesia, blood dyscrasias (e.g., agranulocytosis), cardiac arrhythmias/QT prolongation, hepatic injury, and seizures.